Faculty Bibliography

The demand for the resignation of the studies' coordinator, Dr. Bernard Fisher, followed the finding yesterday of a potentially serious discrepancy in data sent to Pittsburgh by a researcher at a second Montreal hospital, said Dr. Bruce Chabner, a top official of The National Cancer Institute, last night. Chabner said the institute discovered this irregularity while conducting a new investigation of the lumpectomy studies. The investigators found that Fisher's team had come across this discrepancy last September but had failed to follow up on it, thereby violating its own guidelines in conducting the breast cancer studies. The university is expected to comply by replacing Fisher with another senior researcher today , Chabner said. The federal officials say that the data discrepancy may not be significant but that Fisher's failure to make timely reports of the new problem was serious enough for discipline

The University of Pittsburgh has also reanalyzed its data -- excluding those from [Roger Poisson] -- and said that the study's original conclusion remains valid. The cancer institute has reviewed this reanalysis and so far found its methodology correct, but in a further effort to reassure the public, it will audit some raw data. [Bernard Fisher] submitted the report in January to The Journal of the National Cancer Institute without disclosing that statistics from Poisson were included. The editors accepted the paper on March 11 and learned of a possible problem later in the day as The Chicago Tribune prepared its article on the lumpectomy study. Also likely to prove awkward for the institute is an editorial in the same issue written by [Michael A. Friedman] and his colleagues at the cancer institute. The authors commented on Fisher's article without realizing that it included data from Poisson

Auditors will also check the original records at many of the 89 hospitals in the United States and Canada where 1,843 women took part in a surgical study that helped change the way breast cancer is treated by declaring that a partial mastectomy and radiation are just as effective as the more disfiguring full mastectomy. The University of Pittsburgh has also re-analyzed its data -- excluding those from [Roger Poisson] --and said that the study's original conclusion remains valid. The cancer institute has reviewed this re- analysis and so far found its methodology correct, but in a further effort to reassure the public will audit some raw data. The Pittsburgh study, published in 1985, found many women with early breast cancer can be treated with a partial mastectomy, which is also called a lumpectomy, together with radiation

To help restore public confidence in a breast cancer treatment that has been shaken by news of falsification of research data in a major study, federal health officials now plan to audit all documents at the University of Pittsburgh, which coordinated the study. Auditors will check the original records at many of the hospitals where 1,843 women took part in a study that concluded that a partial mastectomy and radiation are just as effective as a full mastectomy

The University of Pittsburgh has also reanalyzed its data -- excluding those from [Roger Poisson] -- and said the study's original conclusion remains valid. The cancer institute has reviewed this reanalysis and so far found its methodology correct, but in a further effort to reassure the public will audit some raw data. [Bernard Fisher] submitted the report in January to The Journal of the National Cancer Institute without disclosing that statistics from Poisson were included. The editors accepted the paper March 11 and learned of a problem later in the day, as the Chicago Tribune prepared its article on the lumpectomy study. Also likely to prove awkward for the institute is an editorial in the same issue, written by [Michael A. Friedman] and his colleagues at the cancer institute. The authors commented on Fisher's article without realizing that it included data from Poisson

The officials plan to audit all documents at the University of Pittsburgh, which coordinated the surgical study. Auditors will also check the original records at many of the 89 hospitals in the United States and Canada where 1,843 women took part in the study that helped change the way breast cancer is treated. It declared that a partial mastectomy and radiation are just as effective as the more disfiguring full mastectomy. The University of Pittsburgh has also re-analyzed its data -- excluding those from [Roger Poisson] -- and said that the study's original conclusion remains valid. The cancer institute has reviewed this re-analysis and so far found its methodology correct. However, in a further effort to reassure the public, it will audit some raw data. The Pittsburgh study, published in 1985, found many women with early breast cancer can be treated with a partial mastectomy, which is also called a lumpectomy, together with radiation

By reviewing medical records, interviewing doctors and patients and testing their blood, epidemiologists traced the cluster in July 1992 to a surgeon-in-training who had not been immunized against the viral liver infection. Over the 10 months, the surgeon, who has not been identified, had been involved in operations on 142 patients at both the U.C.L.A. Medical Center and the Wadsworth Veterans Administration Hospital. Of these, 18, or 13 percent, developed hepatitis B infection. Of at least 155 patients operated on by other surgeons at the two hospitals, none developed hepatitis B. Like H.I.V., the virus that causes AIDS, the hepatitis B virus is transmitted by blood and through sexual contact. But unlike H.I.V., hepatitis B can be prevented by a vaccine. Dr. [Quentin R. Stiles] recently told a group of surgeons that they face a greater risk from hepatitis B than from H.I.V. When he asked how many in the audience had been immunized against hepatitis B, fewer than half said they had, and most of them were younger surgeons. Immunizing surgeons against hepatitis B 'is the kind of thing we ought to be insisting upon,' Dr. Stiles said

Of the 36 states that have the death penalty, 28 require the presence of a doctor at the execution, according to the report. Twenty-three states require that a physician pronounce or determine death in executions, a violation of the widely respected ethical opinions of the American Medical Association. The AMA's ethical guidelines prohibit doctors from assisting in, witnessing or attending executions. The guidelines also ban doctors from rendering technical advice to workers carrying out an execution, and from monitoring, on site or at a distance, the heartbeat or other vital signs of the condemned during the execution process. Since the Supreme Court allowed reinstatement of the death penalty in 1976, many states have allowed executions by injection of drugs. Doctors have been called on to prescribe the lethal drug, insert the needle and tubing to deliver it, and to inspect, test and maintain lethal injection devices, the report said

Of the 36 states that have the death penalty, 28 require the presence of a doctor at the execution, according to the report. Twenty-three states require that a physician pronounce or determine death in executions, a violation of the widely respected ethical opinions of the American Medical Association. The AMA's ethical guidelines prohibit doctors from assisting in, witnessing or attending executions. The guidelines also ban doctors from rendering technical advice to workers carrying out an execution, and from monitoring, on site or at a distance, the heartbeat or other vital signs of the condemned